Hello. This is Ariana Portallatin with the Becker's
Dental and Dia Sobebee podcast. I'm thrilled to
be joined today by doctor Krista Kappas, a
private practice dentist in California.
Doctor Kappas, thank you so much for being
here today. It's great to meet with you.
Thanks for having me. Yes. Definitely.
To start us off for our listeners, can
you introduce yourself and tell us a little
bit about your background?
Yeah. I
well, you've got my name now. Yes.
I went to University of Michigan for dental
school
and practice at a community clinic. And then
I actually worked for a DSO for about
five years
after that, which was great experience.
And my husband and I decided
of sick of the Michigan winters and moved
out to Northern California and purchased our own
practice. We've been here for five years in,
wine country, which has been lovely. But definitely
a change up from the DSL life to
owning a private practice.
Yeah. Yeah. Definitely.
For our first question here, what are some
of the biggest issues that you're following in
the dental industry right now?
I mean, I think
it it goes without saying on, you know,
a lot of the Becker's titles and just
dentistry in general. We're having a huge issue
with staffing shortages.
I mean, I know we're
right now, we,
participate with Delta Dental, and we're one of
the few offices in our area, so we're
slammed. But,
getting good hygienists has been
certainly an an issue for us.
Yeah. Yeah. Definitely. How was your experience with
staffing shortages when you were working at the
DSO in Michigan versus in private practice now
in California?
It was different, but I think
2020 certainly seemed to change everything. So we,
we ended up moving here in 2020, and
I think that was kind of the big
shift to a lot of things that
it really
you know, hiring a hygienist
back in Michigan at that time, you'd put
out an ad, you'd get five to six
applicants.
Several of them would be great. You'd have
a hard time kinda deciding who it was
gonna be. Now it's
I I think we had an ad out
for,
you know, a month and a half. And
with our delta fees, I mean, we're basically
paying everybody to get cleanings
at this point with what we're paying our
hygienists. And it's you know, we're getting people
fresh out of school asking $75
an hour. And Oh, okay. We're fortunate we
did find some really good hygienists. We burned
a good
reputation name in our,
area, so we've been able to find and
recruit some other,
experienced hygienists, but it's definitely not been easy
to find.
Yeah. I know. And this is something that
I've spoken with a lot of practice owners
about too, just the cost of hiring a
hygienist
with the salaries,
that they're asking for.
How have you seen those increase since 2020?
So I think when we purchased our office,
the average
hourly pay for a hygienist was 55 an
hour. Now we're we're at about 80 probably
on average. And then, with that, we do
a bonus system too. So it ends up
being, you know, 5 to $600 a month
extra bonus on top of that, and our
delta fees were
literally for a cleaning getting reimbursed less than
that, but it's just kind of, you know,
that it's it's however you wanna play the
game. You know, we're we're swamped. We're busy.
We've we're
got bodies coming and going. So I I
think we'd rather practice that way, but it's
definitely
you know, it's a challenge.
Yeah. Is that bonus, is that something
that you found to be helpful for recruiting
staff?
Definitely. And I think it's been really good
just, for morale booster too. Basically, what we
do is anything.
We do a percentage of treatment,
planned and accepted, and then also, they have
a daily goal. Anything to get over that
goal, they get a percentage of that as
well.
Nice. Okay.
Next question here. What are you most excited
about when it comes to dentistry right now,
and is there anything that makes you nervous
about the industry?
Yeah.
Excited. There's so much cool technology that's coming
out right now. I mean, right now, we
have,
we've we're a big CEREC office. We love
our CEREC site. I think that makes
participating with insurance doable.
We've been working with Pearl
AI, which has been huge for, patient education.
You pull up their x rays. They've got
everything highlighted and what potentially could need,
billings done, scaling group planning, things like that.
It's just really great for patient education, and
it's great too. There's sometimes that you might
miss something. So it's it's helpful, for our
hygienist to have that pulled up. They've already
had a chance to kinda go through things
with the patients before we step in the
room, so we just have to confirm with
them.
I think AI is just gonna keep getting
better and better. I think scheduling is gonna
get better. You look at where we've come
with chat GPT and things like that over
the years. I think we'll probably get some
more automated online scheduling that just works more
efficiently and with I mean, I'm a millennial.
I think,
the up and coming
generations, nobody wants to call. Nobody wants to
talk to somebody. It's just you wanna go
on your phone, and you wanna get whatever
you need scheduled. You wanna pay your bill
online, and you wanna just get that done
at that moment. If it's 11PM at night,
you wanna just get that scheduled. So I
think that's all
really
coming and developing.
I think three d printing is also I
mean, we have CEREC. It's great, but it's
not for everybody.
We have a Sprint Ray that cost, you
know, the setup for a sprint ray is
about, I mean, maybe a tenth of it.
So I think as that becomes more readily
available,
I mean, three d printing a crown versus
milling a crown, you don't have any over
mill, under mill prepping's a lot easier. So
I think that's gonna keep getting better and
better as materials change too.
Great. Was there anything that makes you nervous
about the industry too? There's a lot of
things that make me nervous. Yeah. Oh, you
know, it's interesting. I had a patient the
other day,
who was in he had a crown done
in 02/2001. You know, he had his World
War two hat on and everything, and he's
been joking with me about, oh, well, I
bet this crown cost 10 times as much
as my crown got done in 02/2001. Like,
well, let's let's check because you've been coming
to this practice for that long. Let me
pull that up. You know what?
Ironically, you're paying $20 less than you paid
in 02/2001. How's that for inflation for you?
But it's just it paints such an interesting
picture of where the dental field is going.
I mean, our every cost has gone up
astronomically for us, staffing costs.
I mean, all of our,
dental supply costs,
your rent,
your everything has gone up, but,
I I do think there needs to be
a massive change in insurance for for us
to be able to provide high quality dental.
I mean, you look at
we do still participate with Delta Dental, which
is a nonprofit
business.
But you look at them, they had a
9,900,000,000.0,
Delta Dental of California, $9,900,000,000
revenue
last year.
And,
you know, they've got their costs, obviously, in
providing the dental care and things like that,
but it's just kind of interesting to look
at in any other field
how much prices have gone up, and ours
have really stayed stagnant or even gone down
over the last couple of years. So I
think that's certainly scary. You know, how are
you gonna continue to be able to pay
and maintain staffing if you're
not getting reimbursed, which you need to get
reimbursed to make that. So that that's certainly
scary. And like we talked about staffing costs
in general, I think, is gonna be a
little bit of a challenge. Keeping people around,
you look at I I think that's been
the talk amongst dentists for the last several
years, and you read an article. I I
think I pulled one article up recently that
was, dental hygiene
magazine, and their
solution to it was, well, you know, dental
hygienists don't wanna stay around. They They don't
wanna work right now. It's negative workplace culture.
There's insufficient pay. They're feeling overworked. I think
there's only so much you can do with
that. You know, we're already paying our hygienist
to be there. We're we're bonusing them. We're
giving them an hour for every procedure. So
there's only so much that you can really
do
before that's, you know, not really the issue.
Yeah. Yeah. Definitely. What changes could be made
to sort of help the the staffing
challenges right now?
I just think there needs to be a
lot of reform in general. So I think
looking at insurance,
it's
basically
been you know, I think I was looking
back at this, you know, in the early
you know, like, in the sixties. Insurance was
truly just you'd go to the dentist, they
would reimburse.
And it's just shifted and shifted and shifted
to where now it's you know, I remember
having to send
preliminary X rays, post op X rays. We're
getting everything
pre authorized before we do treatment.
We have a whole separate department just for
dealing with insurance. We have different companies that
we work with for insurance, and it's just
gotten so complicated.
Insurance maximums haven't changed. So I I definitely
think there needs to be some sort of
insurance reform where or we look at what
the profitability they're actually making. I mean, of
that 9,900,000,000.0
in revenue from Delta,
they did donate a $100,000,000.
You know, I don't know what their exact
profitability is. The CEO made over $30,000,000
last year, which it's a huge company. I
mean, a $9,900,000,000
company should be compensated fairly, but I think
there's we need to take a closer look
at that.
And maybe there's I don't know what the
changes are gonna be, but it's it's not
going in the right direction for dentists to
be able to function. I think staffing wise,
you look
at dental hygiene education.
There really hasn't been an increase in dental
hygiene programs over the last twenty years.
I think it's it's interesting in the state
of California. You can have a expanded functions
dental assistant
who can place fillings. They can use high
speed handpieces. They can use low speed handpieces.
They can put fillings in, but they can't
scale teeth. They can use an ultrasonic cleaner
if they're removing,
ortho cement, but they can't scale teeth. So
I do think
maybe some sort of a shift.
You know, hygienists were there to originally help
release the the burden on,
dentists, but, you know, maybe there's a change
of we've got an expanded functions assistant who
can do simple cleanings, maybe not scaling root
planing, things like that, kit prophines, cleanings, things
like that. But I do think we need
to have just generally
dental education reform, insurance reform.
And with that, I mean, I look at
dental education. You know, you're graduating from school
with $600,000
in debt.
Who's gonna be able to go into the
workforce the way that it's going and make
a $100,000
a year and make that make sense?
Yeah. Yeah. Definitely. A lot of interesting points
that that you've made there.
Our last question here, what will the most
effective health care's leader health care leaders need
to be successful in the next two to
three years?
I I think we just need to roll
with the changes because I think a lot
has changed. I mean, everything that I've talked
about today, we're
we're getting some really cool products with AI
that will make us more efficient, make it
things more cost effective. And I think just
being willing to adapt and get educated to
use these things and be willing to change
is gonna be really crucial to being successful
in the future.
Okay.
Well, that is all I have for you
today, doctor Kappas. Thank you so much for
joining us. Been a pleasure speaking with you
and, looking forward to connecting with you again
in the future. Thank you so much. Thank
you.